Provider Demographics
NPI:1235437294
Name:MIRCHANDANI, KANCHAN ARJAN
Entity Type:Individual
Prefix:
First Name:KANCHAN
Middle Name:ARJAN
Last Name:MIRCHANDANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 WASHINGTON AVE STE 26
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1057
Mailing Address - Country:US
Mailing Address - Phone:410-778-4000
Mailing Address - Fax:
Practice Address - Street 1:711 WASHINGTON AVE STE 26
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1057
Practice Address - Country:US
Practice Address - Phone:410-778-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist